What is the role of cover-uncover test in the workup of diplopia?

Updated: May 21, 2019
  • Author: Jitander Dudee, MD, MA(Cantab), FACS, FRCOphth; Chief Editor: Andrew G Lee, MD  more...
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The cover-uncover test can be used to detect heterotropias. The subject fixates on an object while one eye is covered. If the uncovered eye adducts, the eye has exotropia; if the uncovered eye abducts, the eye has esotropia; if there is upward movement, it has hypotropia; if there is downward movement, it has hypertropia.

If the patient has tropia, the ocular deviation can be measured with prisms. Prisms of differing strengths can be placed in front of the uncovered eye. Prisms of increasing strengths are tested until there is no longer a deviation noted in the uncovered eye.

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